Policy Research Reports

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This series brings to a broad audience the results of World Bank research on development policy. The reports are designed to contribute to the debate on appropriate public policies for developing economies. Titles in this series undergo internal and external review under the management of the Research Group in the World Bank's Development Economics Vice Presidency.

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Improving Effective Coverage in Health: Do Financial Incentives Work?

2022-05-11, de Walque, Damien, Kandpal, Eeshani, Wagstaff, Adam, Friedman, Jed, Neelsen, Sven, Piatti-Fünfkirchen, Moritz, Sautmann, Anja, Shapira, Gil, Van de Poel, Ellen

In many low- and middle-income countries, health coverage has improved dramatically in the last two decades, but health outcomes have not. As such, effective coverage -- a measure of service delivery that meets a minimum standard of quality -- remains unacceptably low. This Policy Research Report examines one specific policy approach to improving effective coverage: financial incentives in the form of performance-based financing (PBF) or financial incentives to health workers on the front lines. The report draws on a rich set of rigorous studies and new analysis. When compared to business-as-usual, in low-income settings with centralized health systems PBF can result in substantial gains in effective coverage. However, the relative benefits of PBF are less clear when it is compared to two alternative approaches, decentralized facility financing which provides operating budget to frontline health services with facility autonomy on allocation, and demand-side financial support for health services (i.e., conditional cash transfers and vouchers). While PBF often results in improvements on the margins, closing the substantial gaps in effective health coverage is not yet within reach for many countries. Nonetheless, there are important lessons learned and experiences from the roll-out of PBF over the last decade which can guide health policies into the future.

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Making Politics Work for Development: Harnessing Transparency and Citizen Engagement

2016-07-11, World Bank

Too often, even reform leaders in countries fail to adopt and implement policies that they know are necessary for sustained economic development. They are encumbered by adverse political incentives, running the risk of losing office should they try to do the right thing. When technically sound policies are selected on paper, implementation through the public system can run into perverse norms of behavior among public officials and citizens to extract private benefits from the public sector at the expense of the greater public interest. Making Politics Work for Development is about how to make politics work for economic development rather than against it. It focuses on research about two forces—citizens’ political engagement and transparency—that explain and hold the potential to improve political incentives and norms of behavior in the public sector. The research shows that the confluence of transparency and political engagement can be a driving force for countries to transition toward better functioning public sector institutions, starting with their own initial and contextual conditions. To harness the potential of these forces, policy actors should target transparency to nourish the quality of political engagement so that citizens can hold leaders accountable for the public goods needed for development.

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Conditional Cash Transfers : Reducing Present and Future Poverty

2009, Fiszbein, Ariel, Ferreira, Francisco H.G., Grosh, Margaret, Olinto, Pedro, Skoufias, Emmanuel

The report shows that there is good evidence that conditional cash transfers (CCTs) have improved the lives of poor people. Transfers generally have been well targeted to poor households, have raised consumption levels, and have reduced poverty, by a substantial amount in some countries. Offsetting adjustments that could have blunted the impact of transfers, such as reductions in the labor market participation of beneficiaries, have been relatively modest. Moreover, CCT programs often have provided an entry point to reforming badly targeted subsidies and upgrading the quality of safety nets. The report thus argues that CCTs have been an effective way to redistribute income to the poor, while recognizing that even the best-designed and best-managed program cannot fulfill all of the needs of a comprehensive social protection system. CCTs therefore need to be complemented with other interventions, such as workfare or employment programs and social pensions. The report also considers the rationale for conditioning the transfers on the use of specific health and education services by program beneficiaries. Conditions can be justified if households are under investing in the human capital of their children, for example, if they hold incorrect beliefs about the returns to these investments; if there is "incomplete altruism" between parents and their children; or if there are large externalities to investments in health and education. Political economy considerations also may favor conditional over unconditional transfers: taxpayers may be more likely to support transfers to the poor if they are linked to efforts to overcome poverty in the long term, particularly when the efforts involve actions to improve the welfare of children.

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Reforming Infrastructure : Privatization, Regulation, and Competition

2004, Kessides, Ioannis N.

Infrastructure industries and services are crucial for generating economic growth, alleviating poverty, and increasing international competitiveness. Safe water is essential for life, and health. Reliable electricity saves businesses and consumers from having to invest in expensive backup systems, or more costly alternatives, and keeps rural women and children from having to spend long hours fetching firewood. Widely available and affordable telecommunications and transportation services can foster grassroots entrepreneurship, and thus are critical to generating employment, and advancing economic development. In most developing and transition economies, private participation in infrastructure, and restructuring have been driven by the high costs, and poor performance of state-owned network utilities. Under state ownership, services were usually under-priced, and making it difficult to expand services. The report indicates that although privatization, competitive restructuring, and regulatory reforms improve infrastructure performance, several issues must be considered and conditions met for these measures to achieve their public interest goals. First, reforms have significantly improved performance, leading to higher investment, productivity, and service coverage and quality. Second, effective regulation-including the setting of adequate tariff levels-is the most critical enabling condition for infrastructure reform. Regulation should clarify property rights, and assure private investors that their investments will not be subject to regulatory opportunism. Third, for privatization to generate widely shared social benefits, infrastructure industries must be thoroughly restructured and able to sustain competition. Thus restructuring, to introduce competition should be done before privatization, and regulation should be in place to assure potential buyers of both competitive, and monopoly elements.

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Violence without Borders: The Internationalization of Crime and Conflict

2020-06-25, World Bank

Just like nearly every aspect of human experience, crime, civil conflict, and violence have become increasingly global. Around the world, civil wars, of which there are more today than at any time since the end of World War II, displace greater numbers of people ever further from their countries of origin. Transnational terrorism has reached a 50-year high, in terms of both its incidence and the number of reported fatalities. Cross-border criminal markets—illicit drugs, human trafficking, wildlife trade, and so forth—take a heavy toll on the many societies they affect. This Policy Research Report, The Internationalization of Crime, Conflict, and Violence, offers a unified framework to take stock of the theoretical and empirical literature on crime, conflict, and violence and to discuss how the international community organizes itself to address security as a regional and global public good. The increasingly global effects of crime and conflict require an equally global response to violence.

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A Measured Approach to Ending Poverty and Boosting Shared Prosperity : Concepts, Data, and the Twin Goals

2015, World Bank Group

In 2013, the World Bank Group adopted two new goals to guide its work: ending extreme poverty and boosting shared prosperity. More specifically, the goals are to reduce extreme poverty in the world to less than 3 percent by 2030, and to foster income growth of the bottom 40 percent of the population in each country. While poverty reduction has been a mainstay of the World Bank’s mission for decades, the Bank has now set a specific goal and timetable, and for the first time, the Bank has explicitly included a goal linked to ensuring that growth is shared by all. The discussion until now has centered primarily on articulating the new goals. This report, the latest in World Bank’s Policy Research Report series, goes beyond that and lays out their conceptual underpinnings, discusses their relative strengths and weaknesses by contrasting them with alternative indicators, and proposes empirical approaches and requirements to track progress towards the goals. The report makes clear that the challenges posed by the World Bank Group’s new stance extend not just to the pursuit of these goals but, indeed, to their very definition and empirical content. The report also argues that an improved data infrastructure, consisting of many elements including the collection of more and better survey data, is critical to ensure that progress towards these goals can be measured, and policies to help achieve them can be identified and prioritized.

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Finance for All? Policies and Pitfalls in Expanding Access

2008, World Bank

This book, finance for all, presents first efforts at developing indicators illustrating that financial access is quite limited around the world and identifies barriers that may be preventing small firms and poor households from using financial services. Based on this research, the report derives principles for effective government policy on broadening access. The report's conclusions confirm some traditional views and challenge others. For example, recent research provides additional evidence to support the widely-held belief that financial development promotes growth and illustrates the role of access in this process. Improved access to finance creates an environment conducive to new firm entry, innovation, and growth. However, research also shows that small firms benefit the most from financial development and greater access-both in terms of entry and seeing their growth constraints relaxed. Hence, inclusive financial systems also have consequences for the composition and competition in the enterprise sector. This report reviews and synthesizes a large body of research, and provides the basis for sound policy advice in the area of financial access. The findings in this report also underline the importance of investing in data collection: continued work on measuring and evaluating the impact of access requires detailed micro data both at the household and enterprise level.

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Moving for Prosperity: Global Migration and Labor Markets

2018-06-14, World Bank

Migration presents a stark policy dilemma. Research repeatedly confirms that migrants, their families back home, and the countries that welcome them experience large economic and social gains. Easing immigration restrictions is one of the most effective tools for ending poverty and sharing prosperity across the globe. Yet, we see widespread opposition in destination countries, where migrants are depicted as the primary cause of many of their economic problems, from high unemployment to declining social services. Moving for Prosperity: Global Migration and Labor Markets addresses this dilemma. In addition to providing comprehensive data and empirical analysis of migration patterns and their impact, the report argues for a series of policies that work with, rather than against, labor market forces. Policy makers should aim to ease short-run dislocations and adjustment costs so that the substantial long-term benefits are shared more evenly. Only then can we avoid draconian migration restrictions that will hurt everybody. Moving for Prosperity aims to inform and stimulate policy debate, facilitate further research, and identify prominent knowledge gaps. It demonstrates why existing income gaps, demographic differences, and rapidly declining transportation costs mean that global mobility will continue to be a key feature of our lives for generations to come. Its audience includes anyone interested in one of the most controversial policy debates of our time.

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Localizing Development : Does Participation Work?

2013, Mansuri, Ghazala, Rao, Vijayendra

The Policy Research Report Localizing Development: Does Participation Work? brings analytical rigor to a field that has been the subject of intense debate and advocacy, and billions of dollars in development aid. It briefly reviews the history of participatory development and argues that its two modalities, community-based development and local decentralization, should be treated under the broader unifying umbrella of local development. It suggests that a distinction between organic participation (endogenous efforts by civic activists to bring about change) and induced participation (large-scale efforts to engineer participation at the local level via projects) is key, and focuses on the challenges of inducing participation. The report provides a conceptual framework for thinking about participatory development and then uses this framework to conduct a comprehensive review of the literature. The framework develops the concept of “civil society failure” and explains its interaction with government and market failures. It argues that participatory development, which is often viewed as a mechanism for bypassing market and government failures by ”harnessing” civic capacity, ought to be seen instead as a mechanism that, if done right, could help to repair important civil society failures. It distills literature from anthropology, economics, sociology, and political science to outline the challenges for effective policy in this area, looking at issues such as the uncertainty of trajectories of change, the importance of context, the role of elite capture and control, the challenge of collective action, and the role of the state. The review of the evidence looks at a variety of issues: the impact of participatory projects on inclusion, civic capacity, and social cohesion; on key development outcomes, such as income, poverty, and inequality; on public service delivery; and on the quality of local public goods. It draws on the evidence to suggest several recommendations for policy, emphasizing the key role of learning-by-doing. It then reviews participatory projects funded by the World Bank and finds the majority lacking in several arenas – particularly in paying attention to context and in creating effective monitoring and evaluation systems that allow for learning.

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At Loggerheads? Agricultural Expansion, Poverty Reduction, and Environment in the Tropical Forests

2007, Chomitz, Kenneth, Buys, Piet, De Luca, Giacomo, Thomas, Timothy S., Wertz-Kanounnikoff, Sheila

There are many causes, consequences, and connections of deforestation and forest poverty in the tropical world. This report specifically addresses the potential dilemma of trade-offs between poverty reduction and environmental protection. It seeks to improve the diagnosis of forest problems and facilitate the prescription and application of solutions by focusing on both the causes and consequences of forest conversion to agriculture and on the nature and location of forest poverty. The first section is diagnostic, examining the drivers and consequences of deforestation and forest poverty. The second part looks at how governance, institutions, and policies shape those drivers. It identifies opportunities for win-win policies. In particular, anything that boosts labor demand outside agriculture will tend to reduce both poverty and deforestation. Additionally, promotion of some kinds of agroforestry can help to improve the ecological functions of degraded forests while boosting farm output and employment. The report offers a systematic framework for thinking about how to integrate forest management with rural development in a sustainable way.